New Worries for Roller Coaster Riders

Jan. 10, 2000 (Atlanta) -- When they tackle the giant rides, roller coaster lovers could be risking a form of brain injury called subdural hematoma, which causes unrelieved headaches, according to a report published by the American Academy of Neurology.

"This type of ride induces up-and-down, to-and-fro, and rotatory acceleration, which [ruptures blood vessels in the brain]," says lead author T. Fukutake, MD, of Ciba University School of Medicine in Japan. The findings "support [previous studies] that ... the acceleration forces associated with roller coaster rides causes the tearing of bridging veins resulting in subdural hemorrhage ... leading to chronic subdural hematoma."

Generally, hematomas occur in older people, and are three times as common in men. The disorder is typically caused by mild but direct head injury, but in 25 to 50% of hematoma cases, there is no history of head trauma, says Fukutake.

The paper cites several recent cases of roller coaster-associated hematomas that have occurred in Japan. Among them is a 26-year-old man who developed hematomas after riding a double-loop, corkscrew-type roller coaster. A 64-year-old man with hypertension had headaches after his first roller coaster ride and developed a hematoma after 11 more rides. In both cases, the hematomas were successfully removed with surgery.

However, a 73-year-old man who had been taking Coumadin (warfarin), a blood thinner prescribed to treat heart disease, developed hematomas five days after a roller coaster ride. Despite surgery, he died 13 days later.

While a subdural hematoma is rare in young women, a 24-year-old Japanese woman developed one after riding three different roller coasters -- each twice -- in one day. One of these was 'Fujiyama,' one of the world's highest (259 feet high) and fastest (81 mph).

The young woman had no head injury and did not lose consciousness during the rides, but after riding she had a constant headache that became worse in the evening. First diagnosed as tension headaches -- she did not mention the roller coaster rides to her doctor -- an MRI two months later showed hematomas, which were surgically removed and left her headache-free.

"Riding roller coasters can cause chronic subdural hematomas even in a previously healthy woman," says Fukutake. "Builders and designers, managers of amusement parks, and potential passengers on giant roller coasters need to be aware of this risk."

Continued

When asked for independent commentary on the study, Stephen Silverstein, MD, tells WebMD. Silverstein is the director of Thomas Jefferson University's Headache Center, in Philadelphia. "What it really means is, if it scares you, don't do it. You have to be careful. If you start to get a headache during one of these rides, you should get medical attention. It can come from two ways, from damage to your neck, like whiplash, or it can come from something more serious, like [subdural hematoma]. It can come immediately [during the ride], or there can be a delay. It takes time sometimes for the blood to build up," he says.

"[The report] is an interesting clinical observation," adds Silverstein. "It's not rocket science, but it's something that hasn't been published a lot. I liked it."

David Hovda, PhD, director of the Brain Injury Program at the University of California, Los Angeles, says, "It's quite common that any time that you have an acceleration or deceleration of the head, that you'll have tearing of bridging veins in the brain that will cause subdural hematoma. We've known that for years. [With roller coasters,] I would be more concerned, personally, with cardiac problems rather than subdural hematoma."

His advice for roller coaster enthusiasts: "Anyone taking blood thinners should stay off anything that may cause an acceleration or deceleration injury. Also, people who are older or who have frail shoulder or neck muscles will have greater likelihood of having a more violent whiplash movement than someone who has stronger muscles and can resist the movement."

Such injuries often have vague, gradually occurring symptoms, says Hovda, "anything from headache to nausea ... double vision, difficulty focusing." Subdural hematoma is "very treatable, very easily taken care of with surgery." However, the length of time that blood touches brain tissue is critical, he adds, because brain tissue will die. "We like to take care of it as soon as possible," he adds.

Vital Information:

Roller coasters have been reported to cause a type of brain injury, called subdural hematoma.

The motions of the ride can cause blood vessels to rupture in the brain, which produces headaches that cannot be relieved and must be surgically treated.

Anyone who experiences a headache following a roller coaster ride, even if it is delayed, should seek medical attention, says one expert.